Key messages

  • People with intersex variations are born with physical, hormonal or genetic features that do not fit the typical expectations for male or female bodies.
  • Intersex variations are natural biological variations and occur in up to 1.7 per cent of all births.
  • People with intersex variations have the same range of sexual orientations and gender identities as non-intersex people.
  • People with intersex variations may experience issues arising from medical treatment in childhood, infertility, disclosure, body image, hormone treatment, bone mineral density and a lack of counselling and support for parents.
  • Health services should understand what intersex is and the difference between intersex and sexual orientation, intersex and trans, and intersex and gender diversity.

Understanding intersex variations

'People with intersex variations' is an umbrella term for people born with physical, hormonal or genetic features that are neither wholly female nor wholly male; or a combination of female and male; or neither female nor male. Intersex variations are not abnormal and should not be seen as ‘birth defects’; they are natural biological variations and occur in up to 1.7 per cent of all births.

Most people with intersex variations are not born with atypical genitalia, however this is common for certain intersex variations. In these cases a decision is made about what sex the child should be raised as shortly after birth. Intersex advocacy groups believe intersex children should be raised as either male or female, but that surgeries to remove physical ambiguities should not occur until the child can provide informed consent.

People with intersex variations may experience a range of issues. In childhood, issues range from access to medical treatment, disclosure of clinical treatments made in infancy, lack of counselling and support for parents and genetic counselling. Issues for adults relate to living with earlier non-consensual medical treatment, being infertile, disclosing their intersex status to partners, having relationships, and physical conditions connected with their specific intersex variation.

Intersex is not about sexual orientation, gender identity or being gender diverse. People with intersex variations have the same range of sexual orientations and gender identities as non-intersex people. Some people with intersex variations identify with the sex they were raised and are heterosexual. Others identify with the sex they were raised and are attracted to people of the same sex or are bisexual. Some people with intersex variations reject the sex they were assigned at birth and identify as the opposite sex, as gender diverse or as neither male nor female.

Discrimination on the basis of someone’s intersex status is prohibited by federal anti-discrimination legislation.

Key issues for health services

Health services should consider the following issues:

  • understanding what intersex is and the difference between intersex and sexual orientation, intersex and trans, and intersex and gender diversity

  • adverse, potentially lifelong health impacts of conducting surgeries on intersex children and/or giving them hormones to 'normalise' their genitals and remove gonads
  • assuming all health issues are related to a person’s intersex status; services should not ask questions related to intersex status unless clinically necessary.

Resources

In order to support people with intersex variations and their families and ensure health providers and systems deliver improved treatment, care and support, the Department of Health and Human Services has worked with a range of stakeholders to develop the following resources:

  • Health and wellbeing of people with intersex variations - Information and resource paper
  • Sex characteristic variations in babies and children - Factsheet for Families
  • Babies with Atypical Genitalia - Factsheet for Families

Health and wellbeing of people with intersex variations - Information and resource paper

The Victorian Government commissioned the Health and wellbeing of people with intersex variations - Information and resource paper to support the development and implementation of evidence-based polices, programs and services, and to further understand the needs and interests of people with intersex variations in Victoria.

Factsheets for families

The factsheets have been developed specifically as a resource to support and help inform families around the health and wellbeing of people with intersex variations as a baby and child.

They include information around next steps, determining if treatment is required and how to access additional information and support.

References

Frader, J., Alderson, P., Asch, A., Aspinall, C., Davis, D., Dreger, A., Edwards, J., Feder, E. K., Frank, A., Hedley, L. A., Kittay, E., Marsh, J., Miller, P. S., Mouradian, W., Nelson, H., and Parens, E., 2004, Health care professionals and intersex conditions, Archives of Pediatrics & Adolescent Medicine 158(5):426-428.

Rosenstreich, G., Comfort, J., and Martin, P., 2011, Primary health care and equity: the case of lesbian, gay, bisexual, trans and intersex Australians, Australian Journal of Primary Health 17(4):302-308.